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Fraud, Fraud Everywhere

Flexibility remains a critical aspect of quickly responding to changing fraud patterns. It is crucial to dynamically expose new patterns of fraud without having to re-program, re-train, or re-invent the underlying systems.

By Christopher Westphal | Updated on August 30, 2009

Virtually every industry is vulnerable to fraud. Each year, fraudulent activities account for billions of dollars lost in the insurance, banking, health care, retail, transportation, manufacturing, and communications industries. Likewise, fraudulent activity riddles our federal and local governments.

The U.S. General Accounting Office estimates that $1 out of every $7 spent on Medicare is forfeited to fraud and abuse. Depending on the reference, Medicare loses up to $20 billion to fraudulent or unnecessary claims each year. The insurance industry estimates that about 25 percent of each premium dollar is spent on covering fraudulent or inflated claims. This puts the yearly costs at an estimated $30 billion nationally.

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